Older adults and people with disabilities who qualify for Medicaid long-term services and supports choose where and how they receive services. They also can choose the amount of support they want in managing in-home providers. Agency with Choice provides an additional support option for hiring and managing a care provider.
Agency with Choice is expected to launch in early 2026.
- There will be no changes to other ways individuals can receive in-home care services when this choice is added.
- With the addition of Agency with Choice, APD will offer four in-home support options.
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Consumer Employer/Homecare Worker
Individuals are the employer. They choose, hire, train, supervise and schedule their workers. The state pays the worker, performs background checks and monitors how things are going. -
Independent Choices Program
Individuals receive cash benefits to purchase their services. The individual determines who to hire, how much to pay the worker and pays the worker. Case managers help the individual ensure that the funding is used appropriately and that their needs are being met. -
In-Home Care Agencies
The agency works with the individual and hires, trains, manages and pays the direct care giver. -
Agency with Choice
The individual shares employment responsibilities with an agency. Individuals choose and train their workers. The agency does tasks such as hiring, paperwork, payroll and background checks.
How the new option will work
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Providers
The Office of Aging and People with Disabilities (APD) and the Oregon Health Authority (OHA) will contract with up to two agencies to provide Agency with Choice services. So far, APD and OHA have chosen one provider agency to deliver Agency with Choice services. -
Worker support
The Agency with Choice provider will serve as the employer of direct support workers and will handle recruitment, hiring, training, termination, payroll and benefits. -
Consumer support
The Agency with Choice provider will help individuals receiving services select and train the worker, set their schedule and responsibilities, and help individuals with planned worker absences or other interruptions in service.
Agency with Choice providers
Under HB 4129, APD and OHA were directed to contract with up to two agencies to provide Agency with Choice services. Information about the
Request for Proposal (RFP) for Agency with Choice providers was posted on the OregonBuys website. This opportunity has closed, and APD and OHA have selected one provider. We will post additional updates here.
This information is being shared as a courtesy only. All official updates about the RFP are provided through
OregonBuys.
Oregon Administrative Rules
The Oregon Department of Human Services has filed permanent rules under OAR Chapter 411, Division 039, which govern the Agency with Choice Program. These rules became effective on Dec. 15, 2025. The official filing and full text of the rules are posted on the Oregon Secretary of State website.
Rules were developed with input from a Rules Advisory Committee and members of the public.
Legislative background
House Bill 4129, passed during the 2024 Legislative Session, established the Agency with Choice provider type for older adults and people with physical disabilities or for people who have a behavioral health need. This new provider type will be available to all individuals who receive in-home services through Medicaid. Agency with Choice will:
- Increase choice for a person receiving services; and
- Offer workers a new option that allows a consumer to direct their own care with more support than Oregon's traditional self-directed models.
Individuals can choose to employ and manager their own worker (the state helps with some of the employer responsibilities), use an in-home care agency or an Agency with Choice.
Agency with Choice is expected to launch in 2026. More information will be provided soon.
Resources
Contact
Email us at awc.info@odhsoha.oregon.gov.